This invention relates to electrodes, and in particular to an electrode and method for locating the recurrent laryngeal nerve in a surgery patient.
A quite serious and recurring problem for otolaryngologists is the post operative side effect of vocal cord paralysis following thyroid surgery. Even the best and most experienced surgeons, using the most sophisticated equipment heretofore available, encounter a substantial hazard that the recurrent laryngeal nerve (RLN) will be severed, stretched or bruised during surgery on or about the thyroid gland. This surgical hazard is a result of several factors, including the fact that the recurrent laryngeal nerve lies just posterior to the most inferior portion of the thyroid gland, and is very small and delicate. Further, it is quite difficult to distinguish this nerve from the background tissue when the area about the thyroid is inflammed, as well as covered with blood following the initial incision. As the result of these aforementioned complications, the risk of vocal cord damage following thyroid surgery is very high, and also is quite serious in that it can result in the patient's complete loss of speech. Even if the laryngeal nerve is simply been stretched or bruised, the loss of speech may last for several months. In the unfortunate cases where the nerve is completely severed, the paralysis is permanent, and surgical attempts to prepare the same have not yet proven successful.
The principal object of the present invention are: to provide an electrode and method for laryngeal electromyography to locate a recurrent laryngeal nerve; to provide such an electrode and method for continuous, intraoperative laryngeal nerve location during thyroid surgery; to provide such an electrode and method which is easily inserted in the patient and adapted for reliable operation; to provide such an electrode and method which is simply and accurate in operation whereby surgeons without extensive experience in thyroid surgery may conduct said surgery, yet avoid damage to the laryngeal nerve; to provide such an electrode having an insulator body and tab connected therewith adapted for insertion into a laryngeal ventricle portion of the patient for preventing inadvertent removal of the electrode from the patient's vocalis muscle; to provide such an electrode and method including an audio monitor, whereby the location of the laryngeal nerve may be determined while the surgeon maintains continuous sight observation of the area of surgery; to provide such an electrode and method including an insertion device for accurately and securely placing the electrode in the patient's vocalis muscle without interfering with other equipment; and to provide such an electrode which is economical to manufacture, efficient in use, and particularly well adapted for the proposed use.
Other objects and advantages of this invention will become aparent from the following description taken in connection with the accompanying drawings wherein are set forth, by way of illustration and example, certain embodiments of this invention.